Why is the number of epilepsies increasing? Epilepsy in adults and features of its course

Previously, the causes of epilepsy were attributed to the intervention of the Gods; it was called "Herculean" or "divine" disease. It was also believed that the disease appeared in magicians, who had carried out the wrong preparation for the ritual of summoning spirits.

Hippocrates was inclined that the problem arose from the sun, winds and cold, which alter the consistency of the brain.

Now this violation has been thoroughly studied, which allows us to define it.

Epilepsy is chronic neurological disease, which manifests itself mainly in the form of sudden seizures. This disease occurs not only in humans, but also in cats, dogs, mice, and some other animals.

The word "neurological" is highlighted for a reason, as many people believe that this disease is caused by mental problems. However, this is just a misconception.

The diagnosis "epilepsy" is made after 2 or more epileptic seizures.

Statistically, about 40-50 million people suffer from epilepsy (5-10% of the total population). Of these, 78% live in developing countries.

Approximately 65-70% of all patients are curable. In 20% of all cases, timely medical intervention can significantly reduce the number of attacks. However, a quarter of epilepsy sufferers do not receive proper treatment.

The risk of hereditary transmission of epilepsy is 3-4%.

75% of people with epilepsy are younger than 20 years old.

Consider a disease such as epilepsy in more detail - its causes and symptoms, modern diagnostics and treatment of pathology.

How does an epileptic seizure occur?

The mechanism of the onset of an attack is determined by the functional the interaction of two indicators of the brain: convulsive focus (zone of structural damage to GM, at the site of which irritation of nerve cells of the motor zone or convulsive edema may occur) and convulsive readiness (the probability of excitation in the cerebral cortex is higher than the level of the ability of the anticonvulsant system of the GM).

In the first case, irritation of the problem area leads to convulsive contractions of the skeletal muscles. The excitement of a part of the brain can spread throughout the GM cortex, which leads to loss of consciousness.

In the second case, the frequency and severity of seizures is determined by the anatomical features of the CGM structure (the higher the convulsive readiness, the easier it is to provoke a seizure).

Types of disease

There are several types of epilepsy.

Classification of the disease according to the causes of its occurrence

Unfortunately, at the moment it is not possible to identify the cause of epilepsy in every diagnosed case. In 6 out of 10 epileptics, doctors find an idiopathic form, that is, epilepsy with no apparent anatomical reason for its occurrence, but presumably its presence is explained by a genetic predisposition.

Epilepsy that has arisen against the background of certain factors is called symptomatic (or secondary):

• structural defects of the brain: cyst, hemorrhage, tumor, malformations in the development of the brain, abnormalities in the structure of the brain (for example, in some genetic syndromes), a blood clot or rupture of a vessel causing a stroke;
• : encephalitis, meningitis, neurocysticercosis and others;
• mechanical damage to the head;
• sudden withdrawal of sedatives or sleeping pills;
• abrupt cessation of alcohol consumption;
• negative effects on the brain in the womb or during childbirth (hypoxia, birth trauma, insufficient birth weight).

Cryptogenic (or "genuinic") epilepsy is also distinguished, when there are no genetic or anatomical reasons for the onset of the disease.

The categories "idiopathic" and "cryptogenic" epilepsy overlap, since hereditary epilepsy, like cryptogenic epilepsy, is not reflected in any way during the study of the patient's brain.

Classification depending on the factor provoking the disease

Allocate:

• primary (occurs due to increased convulsive readiness of the brain, congenital or early acquired type);
• secondary, or focal (occurs as a result of damage to GM - mechanical or infectious);
• reflex (appears due to an external stimulus, each patient may have his own: bright or flickering light, noise, smell ...).

Classification, depending on clinical and syndromic features

There are such views:

• epilepsy with propulsive, minor seizures (typical of infancy);
• with myoclinic seizures (early childhood form);
• with impulsive seizures (most often during puberty);
• with psychomotor seizures (adversive, sensory, auditory, oral seizures, fits of laughter, which can be combined with seizures, or can proceed on their own).

Types of paroxysms

Here they single out everything two kinds:

• accompanied by convulsive paroxysms (seizures);
• non-convulsive paroxysms.

Dependence on the frequency and rhythm of seizures

Allocate:

• epilepsy with rare / frequent seizures (frequent - several times a week, rare - less than once a month);
• epilepsy with increasing and irregular seizures.

signs of generalized epilepsy

Depending on the time of occurrence

Main types three:

• epilepsy of awakening;
• epilepsy at night;
• generalized (can occur at any time).

Depending on the localization of the epilepsy focus

By localization:

• temporal;
• cortical;
• occipital;
• diencephalic, etc.

Separately, epileptic reactions are distinguished as a form of epilepsy.

When the cause of the epileptic reaction is eliminated, the problem disappears completely.

Who is at risk of developing the disease

At risk includes:

1. People whose brain is affected by infections, vascular diseases (for more details, see the description of symptomatic epilepsy).
2. With abnormalities in the development of the brain.
3. Who has family members (s) suffering from this disease.
4. Whose activities are associated with possible head injuries ( different kinds struggle, construction).
5. Over 60 years of age (due to weakened immunity, increased risk of problems with blood vessels).
6. Children under 12 years of age (increased likelihood of injury, active period infectious diseases - chickenpox, measles - which can negatively affect the work of GM).

Symptoms and signs of the disease

Specific signs and symptoms of epilepsy and its consequences - epileptic seizures depend on the area of \u200b\u200bbrain damage (focal or generalized epilepsy) and how far it has spread.

In addition to the "common" seizure, there may be temporary symptoms: disorientation, loss of consciousness, movement disorders, disturbances in taste, sound or visual perception, sudden changes in mood, aggressiveness, numbness of a part of the body - typical for focal lesions.

Epilepsy manifests itself as seizures throughout the body, short stop breathing, twitching, biting the tongue, screaming, urinary incontinence. It can proceed without convulsions (trembling of the eyelids, slight throwing of the head, inability to look away from one point).

Also, people with epilepsy are more likely to suffer from fractures, their skin more prone to damage.

Their immunity less resistant to other diseases, they can often suffer from psychoemotional disorders (depression, anxiety), the range of interests can narrow, the character can become more picky and petty, easily pass from a calm state to aggression.

Vindictive, vindictive (classified as "epileptic in nature").

But not always signs of epilepsy in adults or children can be seen by others or identified as epileptic.

Types of epileptic seizures

Epileptic seizures can manifest themselves quite multifaceted - from general seizures to a barely noticeable several-second blackout.

Sometimes there are visual hallucinations (sensation of changing the shape of objects), eye twitching, abdominal discomfort, tingling in the finger, trance state, short-term deprivation of speech, and the like.

There are more than 30 types of epileptic seizures.

The international classification of epileptic seizures distinguishes generalized (applies to all areas of GM) and partial (focal, focal) seizures.

They are divided into subspecies: absences, tonic-clonic seizures, complex and simple partial seizures, etc.

Aura

Usually has the following signs: increased body temperature, anxiety, anxiety, auditory, gustatory, visual hallucinations, abdominal discomfort, deja vu for no reason or unrecognizability of what was previously seen, dizziness.

Generalized seizures

This is epilepsy in which the seizure affects both hemispheres of the GM.

Generalized include tonic-clonic seizures, absences.

Such seizures are diagnosed in 40% of patients with epilepsy.

Tonic-clonic seizures

They accompanied byloss of consciousness, tension of the trunk, legs, arms (tonic convulsions), twitching of the body and limbs (clonic convulsions).

Sometimes it is possible to hold the breath for a short time, but asphyxiation does not occur due to. The attack usually lasts 1-5 minutes. After a seizure, the patient can sleep for a while, feel some deafness, lethargy, less often - headache.

If there was a focal attack or aura before the tonic-clonic one, then the manifested symptomatology is defined as a partial attack with secondary generalization.

Absances

These are short-term blackouts (1-30 sec), not accompanied by convulsions.

the first signs of epilepsy in children - absence

Absancies can occur quite often - up to 100-300 seizures per day.

But they are rarely noticed by others, attributing to a pensive state.

The aura does not occur before this type of attack.

During the seizure, the movement of the epileptic stops abruptly, the gaze freezes (becomes lifeless and empty), there is no reaction to the outside world.

Sometimes there are eye rolls, discoloration of the skin on the face.

After this kind of "pause", the person continues to move as if nothing had happened.

The first signs of epilepsy in children are often absences. May develop into more complex seizures over time.

Myoclonic epilepsy

Most typical for adolescence (a high chance of occurrence during puberty and up to 20 years).

Characterized very sharp and quick twitching of the hands, sometimes accompanied by a tonic or tonic-clonic attack. The patient usually remains conscious.

This type of seizure often occurs a few hours after waking up or up to 1–2 hours before bedtime.

Additionally, increased photosensitivity is noted.

Myoclonic epilepsy is relatively easy to treat.

Partial (focal, focal) seizures

They arise as a result of paroxysmal electrical activity in a separate area of \u200b\u200bthe GM. Occur in 60% of patients with epilepsy. Distinguish between simple and complex partial attacks:

1. During simple attacks the person retains consciousness. Manifested by twitching or discomfort in certain parts of the body. Often, simple partial seizures are aura-like.
2. Complex attacks characterized by impaired consciousness and pronounced movement disorders.

For the treatment of partial seizures, a neurological examination of the problematic area of \u200b\u200bthe brain is performed in order to exclude possible concomitant diseases.

Rolandic attacks

Signs of rolandic epilepsy occur in children 6-12 years old. Manifest partial symptoms (swallowing, twitching of the corner of the mouth, drooling). Usually occurs during sleep.

They respond well to treatment.

Status epilepticus

This concept is characterized by a high frequency of epileptic seizures (follow without interruption, one after the other). This phenomenon threatens human life.

In case of status epilepticus, urgent delivery to the intensive care unit is required.

Pseudo-seizure

This state is consciously or unconsciously caused by the person himself, outwardly very similar to a real attack. Often a pseudo-seizure occurs in stressful situations or with a lack of attention.

Basically an attack mimics a child's or female body, with hysteria, conflicts, certain mental deviations.

After pseudo-seizures, a person very quickly returns to normal. It is extremely rare that there will be any damage to the body or further negative psychological manifestations. With the help of an EEG, a pseudo-seizure can be detected.

It is extremely important to diagnose this seizure in a timely manner so that the "patient" does not start drug treatment without real need.

More about childhood seizures

Childhood epilepsy is very different from the course of the disease in adults.

The signs of epilepsy in infants are as follows. tonic seizures (due to the predominant functioning of the brain stem parts). Very often and x is confused with the child's normal motor activity.

Childhood spasm (2-5 years) is manifested by involuntary adduction of the arms to the chest, tilting the body or head forward, straightening the legs. Most often, an attack can occur in the morning after waking up; lasts a few seconds.

Sometimes the spasm is localized in a small area of \u200b\u200bthe muscles (expressed, for example, by involuntary nodding of the head). By age 6, seizures can either stop or develop into another type of epilepsy.

Clonic (atonic) seizures occur at the age of 7-15 years.

In this case, the symptoms of epilepsy in children characterized by sudden loss of consciousness (as a result of relaxation of all muscle groups). From the outside it may look like a normal fainting spell.

Others possible signs epilepsy in children:

• nightmares, awakening with tears and screams;
• sleepwalking;
• headaches (sharp, accompanied by vomiting and nausea);
• short-term inability to speak, answer questions.

Of course, the presence recent symptoms does not necessarily mean epilepsy. However, if you have certain suspicions, it is better to additionally consult a doctor, undergo an examination if necessary.

Diagnostic techniques

To identify the disease need to:

• be extremely attentive to your body and changes in state (if we are talking about a child, then be vigilant to the course of his psychomotor reactions);
• go to a doctor's consultation, describe in detail what is happening to you (what worries you, how often);
• provide a family history;
• if necessary, electroencephalography, CT, MRI are performed.

First aid for a seizure

If you have a life-threatening seizure, turn him over onto his stomach and place a pillow under his head. If vomiting occurs, turn it on its side (to prevent the masses from getting into airways).

Insert something hard between your teeth (to prevent your tongue from biting). Do not give him water, do not hold him in a certain position by force.

Be sure to call your doctor.

Treatment of the disease

Treatment depends on the mechanism causing the disease. If the disease is caused by a malfunction of the GM, then eliminating the main problem will help get rid of the seizures.

If epilepsy is caused by anatomical or genetic causes, drugs are prescribed to help minimize or eliminate seizures. Sometimes surgery may be ordered.

Prevention of epilepsy

The causes of epilepsy in adults and children can be completely different.

Hereditary epilepsy is virtually impossible to prevent.

Symptomatic can be preventedavoiding head injuries, infectious diseases.

Also worth minimizing the amount of alcohol, strong tea and coffee, overeating, temperature fluctuations (overheating or hypothermia of the body).

Frequently stay outdoors, exercise daily, do not overwork, eat healthy foods, and eat enough dairy products.

Possible complications

It is worth noting such:

• an increase in the number of seizures, up to status epilepticus;
• aspiration pneumonia (caused by inhalation foreign objects, food particles, vomit during an attack);
• sudden death (especially with a seizure with extensive seizures, or a seizure in water, extreme recreation)
• injury (when falling);
• an attack in a pregnant woman threatens the development of fetal malformations;
• negative emotional states, asociality.

Timely diagnosis of the disease is a step towards recovery!

Video: Epileptic seizure in West syndrome

The child has seizures of epilepsy several times a day. The disease is complicated by West syndrome and cerebral palsy.

A disease such as epilepsy is chronic in nature, while it is characterized by the manifestation of spontaneous, rarely occurring, short-term seizures of epileptic seizures. It should be noted that epilepsy, the symptoms of which are very pronounced, is one of the most common neurological diseases - for example, every hundredth person on our planet experiences recurrent epileptic seizures.

Epilepsy: the main features of the disease

When considering cases of epilepsy, you can see that it itself has the nature of a congenital disease. For this reason, her first attacks occur in childhood and adolescence, 5-10 and 12-18 years, respectively. In this situation, no damage in the brain substance is determined - only the electrical activity characteristic of nerve cells changes. There is also a decrease in the threshold of excitability in the brain. Epilepsy in this case is defined as primary (or idiopathic), its course is benign, in addition, it is also amenable to effective treatment... It is also important that in case of primary epilepsy developing according to the indicated scenario, the patient with age can completely exclude taking pills as a necessity.

As another form of epilepsy, secondary (or symptomatic) epilepsy is noted. Its development occurs after damage to the brain and its structure in particular, or in case of metabolic disorders in it. In the latter case, the occurrence of secondary epilepsy is accompanied by a complex number of pathological factors (underdevelopment of brain structures, previous traumatic brain injuries, dependence in one form or another, tumors, infections, etc.). The development of this form of epilepsy can occur regardless of age; the disease in this case is much more difficult to treat. Meanwhile, a complete cure is also a possible outcome, but only if the underlying disease, which provoked epilepsy, is completely eliminated.

In other words, epilepsy is divided into two groups according to its occurrence - this is acquired epilepsy, the symptoms of which depend on the underlying causes (the listed injuries and diseases) and hereditary epilepsy, which, accordingly, arises due to the transfer of genetic information to children from parents.

Types of epilepsy seizures

The manifestations of epilepsy appear, as we noted, in the form of seizures, while they have their own classification:

• Based on the cause (primary epilepsy and secondary epilepsy);
• Based on the location of the original focus, characterized by excessive electrical activity (deep parts of the brain, its left or right hemisphere);
• Based on a variant that forms the development of events during an attack (with or without loss of consciousness).

With a simplified classification of epileptic seizures, seizures are distinguished generalized partial.

Generalized seizures are characterized by seizures in which complete loss of consciousness is observed, as well as control over the actions performed. The reason for this situation is excessive activation, characteristic of the deep parts of the brain, which subsequently provokes the involvement of the whole brain. The result of this condition, which is expressed in a fall, is not at all obligatory, because muscle tone is disturbed only in rare cases.

As for this type of seizures, as partial seizures, it can be noted here that they are typical for 80% of the total number of adults and for 60% of children. Partial epilepsy, the symptoms of which appear when a focus with excessive electrical excitability is formed in a particular area in the cerebral cortex, directly depends on the location of this focus. For this reason, the manifestations of epilepsy can be motor, mental, vegetative, or sensitive (tactile).

It should be noted that partial epilepsy, as localized and focal epilepsy, the symptoms of which are a separate group of diseases, have metabolic or morphological damage to a specific part of the brain in their own development. They can be caused by various factors (brain injury, infections and inflammatory lesions, vascular dysplasia, acute type of cerebrovascular accident, etc.).

When a person is in a state of consciousness, but with a loss of control over a certain part of the body, or when he has sensations that were previously unusual, we are talking about simple attack... If there is a violation of consciousness (with a partial loss of it), as well as a lack of understanding by a person of exactly where he is and what is happening to him at the moment, if entering into any contact with him is not possible, then this is difficult attack... As with a simple attack, in this case, movements of an uncontrolled nature are made in one or another part of the body, often an imitation of specifically directed movements occurs. Thus, a person can smile, walk, sing, talk, "hit the ball", "dive", or continue the action that he began before the attack.

Any type of seizure is short-term, with a duration of up to three minutes. Almost every seizure is accompanied by drowsiness and confusion after the seizure is over. Accordingly, if during an attack there was a complete loss of consciousness or its disturbances occurred, the person does not remember anything about him.

The main symptoms of epilepsy

As we have already noted, epilepsy is generally characterized by the onset of an extensive convulsive seizure. It begins, as a rule, suddenly, and without having any logical connection with external factors.

In some cases, it is possible to establish the time of the imminent onset of such a seizure. Within one or two days, epilepsy, the early symptoms of which are expressed in general malaise, also indicates impaired appetite and sleep, headaches and excessive irritability as its early precursors. In many cases, the appearance of a seizure is accompanied by the appearance of an aura - for the same patient, its character is defined as stereotypical in the display. The aura lasts for several seconds, followed by loss of consciousness, possibly a fall, often accompanied by a kind of cry, which is caused by a spasm arising in the glottis during muscle contraction chest and diaphragm.

At the same time, tonic convulsions occur, in which both the trunk and the limbs, being in a state of tension, are stretched, and the head is thrown back. In this case, breathing is delayed, the veins in the neck area swell. The face acquires a deathly pallor, the jaws contract under the influence of convulsions. The duration of the tonic phase of the seizure is about 20 seconds, after which clonic seizures appear, manifested in jerky contractions of the muscles of the trunk, limbs and neck. In this phase of the seizure, lasting up to 3 minutes, breathing often becomes hoarse and noise, which is explained by the accumulation of saliva, as well as the sinking of the tongue. There is also a release of foam from the mouth, often with blood, which occurs due to biting the cheek or tongue.

Gradually, the frequency of seizures decreases, their end leads to complex muscle relaxation. This period is characterized by a lack of reaction to any stimuli, regardless of the intensity of their impact. The pupils are in a dilated state, there is no reaction to light. Reflexes of a deep and protective type are not evoked, however, urination of an involuntary character occurs quite often. Considering epilepsy, one cannot fail to note the vastness in its varieties, and each of them has its own peculiarities.

Epilepsy of the newborn: symptoms

In this case, neonatal epilepsy, the symptoms of which occur against a background of fever, is defined as intermittent epilepsy. The reason for this is the general nature of the seizures, in which seizures pass from one limb to the other and from one half of the body to the other.

The formation of foam, which is usual for adults, as well as biting the tongue, as a rule, are absent. At the same time, it is also extremely rare for epilepsy and its symptoms in infants to be defined as relevant phenomena characteristic of older children and adults, and expressed in the form of involuntary urination. There is also no post-attack sleep. Already after the return of consciousness, it is possible to reveal a characteristic weakness on the left or right side of the body, its duration can be up to several days.

Observations indicate, in epilepsy in infants, symptoms foreshadowing an attack, which consist of general irritability, headache, and appetite disturbances.

Temporal epilepsy: symptoms

Temporal epilepsy occurs due to the influence of a certain number of reasons, but there are primary factors contributing to its formation. So, this includes birth trauma, as well as brain damage that develops with early age due to injuries received, including inflammatory processes and other types of occurrence.

Temporal epilepsy, the symptoms of which are expressed in polymorphic paroxysms with a peculiar aura preceding them, has a duration of manifestations of the order of several minutes. Most often, it is characterized by the following features:

• Feelings of an abdominal nature (nausea, abdominal pain, increased peristalsis);
• Cardiac symptoms (palpitations, pain in the heart,);
• Shortness of breath;
• The occurrence of involuntary phenomena in the form of sweating, swallowing, chewing, etc.
• The emergence of changes in consciousness (loss of connection of thoughts, disorientation, euphoria, calmness, fears);
• Performing actions dictated by a temporary change in consciousness, lack of motivation in actions (undressing, picking up things, trying to escape, etc.);
• Frequent and severe personality changes, expressed in paroxysmal mood disorders;
• A significant type of autonomic disorder that occurs in the intervals between attacks (changes in pressure, violation of thermoregulation, of various kinds allergic reactions, disorders of the metabolic endocrine type, disorders in sexual function, disorders in water-salt and fat metabolism, etc.).

Most often, the disease has a chronic course with a characteristic tendency to gradual progression.

Epilepsy in children: symptoms

A problem such as epilepsy in children, the symptoms of which you already know in their general form, has a number of its own characteristics. So, in children it occurs much more often than in adults, while its reasons may differ from similar cases adult epilepsy, and, finally, not every seizure that occurs among children is attributed to such a diagnosis as epilepsy.

The main (typical) symptoms, as well as signs of seizures of epilepsy in children, are as follows:

• Convulsions, expressed in rhythmic contractions characteristic of the muscles of the body;
• Temporary holding of breath, involuntary urination, and loss of feces;
• Loss of consciousness;
• Extreme muscle tension in the body (straightening the legs, bending the arms). Disorderly movements of any part of the body, expressed in twitching of the legs or arms, wrinkling or drawing together of the lips, throwing back the eyes, forcing the head to turn to one side.

In addition to the typical forms, epilepsy in children, like epilepsy in adolescents and its symptoms, can be expressed in forms of a different type, the features of which are not immediately recognized. For example, absence epilepsy.

Absolute epilepsy: symptoms

The term absence from French is translated as "absence". In this case, with an attack of falling and no convulsions - the child simply freezes, ceasing to react to the events that are happening around. For absence epilepsy, the following symptoms are characteristic:

• Sudden freezing, interruption of activity;
• Absent or gaze focused on one point;
• Inability to attract the child's attention;
• Continuation of the action begun by the child after the seizure with the exclusion of the period of time with the seizure from memory.

Often this diagnosis manifests itself at about 6-7 years old, while girls get sick more often about twice as much as boys. In 2/3 of cases, children have relatives with this disease. On average, absence epilepsy and symptoms last up to 6.5 years, then become less frequent and disappear, or develop over time into another form of the disease.

Rolandic epilepsy: symptoms

This type of epilepsy is one of the most common forms of epilepsy for children. It is characterized by a manifestation mainly at the age of 3-13 years, while the peak of its manifestation falls on the age of about 7-8 years. The onset of the disease for 80% of the total number of patients occurs at the age of 5-10 years, and, in contrast to the previous, absence epilepsy, it differs in that about 66% of patients with it are boys.

Rolandic epilepsy, the symptoms of which are, in fact, typical, manifests itself in the following conditions:

• The appearance of a somatosensory aura (1/5 of the total number of cases). It is characterized by paresthesia (an unusual feeling of numbness of the skin) of the muscles of the larynx and pharynx, cheeks with one-sided localization, as well as numbness of the gums, cheeks, and sometimes the tongue;
• The onset of clonic unilateral, tonic-clonic seizures. In this case, the muscles of the face are also involved in the process; in some cases, cramps can spread to the leg or arm. Involvement of the tongue, lips and pharyngeal muscles leads to the child's description of sensations in the form of "shifting towards the jaw", "knocking teeth", "trembling of the tongue" .;
• Difficulty speaking. They are expressed in the exclusion of the possibility of pronouncing words and sounds, while the stop of speech may occur at the very beginning of an attack or is manifested in the course of its development;
• Profuse salivation (hypersalivation).

A characteristic feature of this type of epilepsy also lies in the fact that it mainly occurs at night. For this reason, it is also defined as nocturnal epilepsy, the symptoms of which in 80% of the total number of patients occur in the first half of the night and only 20% in the state of wakefulness and sleep. Nocturnal convulsions have certain features, which, for example, consist in their relative short duration, as well as in a tendency to subsequent generalization (spread of the process through an organ or an organism from a focus of limited scope).

Myoclonic epilepsy: symptoms

This type of epilepsy, myoclonic epilepsy, whose symptoms are characterized by a combination of twitching in severe epileptic seizures, is also known as myoclonus epilepsy. Amazes given view diseases of both sexes, while morphological cellular studies of the cells of the spinal cord and brain, as well as the liver, heart and other organs in this case reveal the deposits of carbohydrates.

The disease begins at the age of 10 to 19 years, characterized by symptoms in the form of epileptic seizures. Later, myoclonus also occurs (muscle contractions of an involuntary nature in full or partial volume with or without a motive effect), which determines the name of the disease. Psychic changes are often used as a debut. As for the frequency of seizures, it is different - it can occur both daily and with a frequency of several times a month and less often (with appropriate treatment). Consciousness disorders are possible along with seizures.

Post-traumatic epilepsy: symptoms

In this case, post-traumatic epilepsy, the symptoms of which, as in other cases, are characterized by seizures, is directly related to brain damage resulting from head trauma.

The development of this type of epilepsy is relevant for 10% of those people who have experienced severe head injuries, with the exception of penetrating brain injuries. The likelihood of epilepsy with penetrating brain injury increases to 40%. Manifestation characteristic symptoms is possible even after several years from the moment of injury, while they depend directly on the area with pathological activity.

Alcoholic epilepsy: symptoms

Alcoholic epilepsy is an inherent complication of alcoholism. The disease manifests itself in convulsive seizures that occur suddenly. The onset of an attack is characterized by loss of consciousness, after which the face acquires severe pallor and gradual cyanosis. Often, foam appears from the mouth during a seizure, vomiting occurs. The cessation of seizures is accompanied by a gradual return of consciousness, after which the patient often falls asleep for up to several hours.

Alcoholic epilepsy is expressed in the following symptoms:

• Loss of consciousness, fainting;
• Seizures;
• Strong pain, "Burning";
• Muscle contraction, feeling of squeezing, tightening of the skin.

The onset of a seizure can occur within the first few days after stopping alcohol intake. Often, seizures are accompanied by hallucinations characteristic of alcoholism. The cause of epilepsy is long-term alcohol poisoning, especially when using surrogates. An additional impetus can be a previous traumatic brain injury, an infectious type of disease, etc.

Non-convulsive epilepsy: symptoms

The non-convulsive form of seizures in epilepsy is a fairly common variant of its development. Non-convulsive epilepsy, the symptoms of which can be expressed, for example, in twilight consciousness, manifests itself suddenly. Its duration is on the order of several minutes to several days with the same sudden disappearance.

In this case, there is a narrowing of consciousness, in which of the various manifestations inherent in outside world, the patient perceives only that part of the phenomena (objects) that are emotionally significant for them. For the same reason, hallucinations and various delusional ideas often occur. Hallucinations have an extremely frightening character when their visual form is painted in gloomy tones. This condition can provoke an attack on others with injuries, often the situation is fatal. This type of epilepsy is characterized by mental disorders, accordingly, emotions are manifested in the extreme degree of their expression (rage, horror, less often - delight and ecstasy). After seizures, patients forget what is happening to them, much less often residual memories of events can appear.

Epilepsy: first aid

Epilepsy, the first symptoms of which can frighten an unprepared person, requires some protection of the patient from potential injury during a seizure. For this reason, in case of epilepsy, first aid involves providing the patient with a soft and flat surface under him, for which soft things or clothes are placed under the body. It is important to free the patient's body from constricting objects (first of all, this concerns the chest, neck and waist). The head should be turned to one side, giving the most comfortable position for exhaling vomit and saliva.

Neurological diseases are sometimes similar in appearance to each other, but epilepsy is so striking and unlike other ailments that even a person without medical education can recognize its symptoms.

This pathology manifests itself in different ways and can manifest itself at any age. Unfortunately, the disease cannot be cured, however modern therapy can prolong remission by long yearsthat will allow a person to live a full life.

We will talk further about how epileptic seizures manifest in an adult, with which seizures an epileptic seizure begins, how dangerous this condition is.

Epilepsy is characterized by recurring seizures that can manifest in different ways.

A single epileptic seizure can occur with completely a healthy person, after overwork or intoxication.

But it is the attacks of epilepsy that are repetitive and are not influenced in any way by external factors.

Where does it start and how long does it last

Under the influence of certain risk factors, a group of neurons appears in the brain that easily become excited in response to the smallest process in the brain.

Doctors call this the formation of an epileptic focus. The nerve impulse arising in this focus expands to neighboring cells and forms new centers.

Constant connections are created between the foci, which is expressed by protracted, various attacks: the affected motor neurons cause repetitive movements or, on the contrary, freezing of movements. Visuals provoke hallucinations.

An epileptic attack develops suddenly and cannot be predicted or stopped. It can pass with a complete loss of consciousness, with a picture of a man beating on the ground with foam at his mouth. Or without losing consciousness.

A large generalized attack is characterized by convulsions, banging of the head on the floor, and frothing at the mouth. The episode lasts no more than a few minutes, then the convulsions subside, replaced by noisy breathing.

All muscles relax; urination is possible.

The patient falls asleep, lasting from several minutes to several hours.

If the patient does not fall asleep, then gradually comes to his senses.

The episode is not remembered. The person feels overwhelmed, complains of headache and drowsiness.

How often are

Epileptic seizures have a certain frequency, which is taken into account by the doctor when prescribing and analyzing the effectiveness of the therapy.

Seizures occurring once a month are considered rare, and 2 to 4 times are average. Frequent seizures of epilepsy - more than 4 per month.

This pathology progresses, therefore, over time, the frequency increases, and only competently selected ones can help here.

Causes of occurrence in an adult

The first seizures of epilepsy in adults can occur for a variety of reasons, and you can never predict what will serve as a catalyst for the manifestation of the disease.

Most often called, but it is not at all necessary that he will play a role. The disease propensity is encoded in the genes and is passed on to the next generation. When unfavorable conditions are created, it transforms into a disease.

After a binge

Ethyl alcohol is a strong poison.

In chronic alcoholism, delivered by blood to brain cells, it causes their oxygen starvation and death.

Irreversible pathological processes begin in the cerebral cortex, leading to seizures.

The first attack happens just in alcoholic intoxication and lasts a few seconds, but with systematic binges, short episodes occur more often and last longer.

Most often, among the ancestors of such a patient, you can find people who suffered from chronic alcoholism or epilepsy.

After injuries

This is a rare but treatable condition. Treatment is complicated by severe complications associated with the underlying pathology, which most often appears after trauma to the cerebral cortex, or a violation of blood supply.

After a stroke

Epilepsy is not uncommon after a stroke, when the brain of an elderly person is very worn out and cannot cope with the consequences of tissue infarction.

The likelihood of its occurrence with a hemorrhagic stroke is two times higher than with an ischemic one.

Almost always, epilepsy occurs when the cerebral cortex is affected and almost never when the cerebellum, hypothalamus and deep layers of the brain are affected.

Other factors

It is customary to distinguish between two sets of reasons: primary and secondary.

Primary can be:

• heredity;
• intrauterine infection;
• birth injury.

The secondary develops after a negative external effect on the brain. These reasons include:

• infections (meningitis, encephalitis);
• tumors;
• cerebrovascular anomalies;
• overwork and stress.

How do epileptic attacks manifest

They are very diverse in nature. There are cases when there are no seizures at all.

The main ones are:

1. Change in taste and smell;
2. Visual hallucinations;
3. Change in psyche and emotions;
4. Strange sensations in the stomach;
5. Pupil changes;
6. Loss of contact with reality;
7. Uncontrolled movements (twitching);
8. Loss of movement, gaze fixation;
9. Confused consciousness;
10. Convulsions.

These conditions can occur before or instead of attacks. At first, they last no more than a few seconds. The most striking manifestation of epilepsy is considered a seizure.

Classification

First of all, attacks of the disease are distinguished by the degree of damage:

1. Partial seizures (local) - caused by a lesion in one hemisphere of the brain.

   They are not dangerous to life, the degree of intensity is not too high.

   These episodes, together with absences, are referred to as minor seizures.

2. Generalized seizure- the entire brain is involved. High intensity. Complete loss of consciousness occurs. Such an attack is life-threatening.

Partial (small)

It manifests itself in different ways, depending on which system of the body it affects.

Seizure type	Characteristic
Motor	Spontaneous, uncontrollable movements of small areas of the body, shouting out words or sounds due to spasm of the larynx. Loss of consciousness is possible.
Sensory	Unusual sensations: burning sensations on the skin, buzzing in the ears, body tingling, phantom odors, or increased sense of smell. Sparkles in the eyes, taste sensations.
Vegetative-visceral	Feelings of emptiness in the stomach, or movement internal organs... Increased thirst and salivation. Growth blood pressure... There is usually no loss of consciousness.
Mental	Memory lapses, thinking disorders, mood swings, a feeling of unreality of what is happening. The patient ceases to recognize loved ones, experiences unreasonable feelings. Hallucinations.

These episodes can last for hours, or even days, when the patient performs the correct actions in a complete absence of consciousness. Upon regaining consciousness, he does not remember anything about the attack itself.

Partial seizures can result in secondary generalization, with convulsions and complete loss of consciousness.

This is usually evidenced by motor, sensory, autonomic and mental paroxysms that occur a few minutes before an epileptic seizure.

This state is called an aura. Since recurring episodes are usually of the same type, it is the aura that can help prepare for the attack, ensuring yourself safety: lie down on a soft or call for help.

Generalized (large)

This form of seizures is a direct threat to the patient's life. Since the entire brain is captured, consciousness is completely lost.

Seizure type	Time	What are the characteristics of seizures
Simple absence		Loss of consciousness for a few seconds.
Difficult absence		Accompanied by movement (gestures, rapid breathing).
Myoclonic		Muscle contractions: moving the head, shrugging the shoulders, squatting, swinging the arms.
Tonic		Flexion-extension of the limbs.
Clonic	Up to several minutes	Vibration of the limbs (epileptic seizures), foam at the mouth, redness of the face.
Tonic-clonic	A couple of minutes	Contraction of the muscles of the larynx, foam (sometimes bloody from biting the tongue), redness of the face. The mortality rate from this seizure reaches 50%.
Atonic	Few seconds	Loss of tone in any part of the body (falling of the body, falling of the head to one side).

Any of these seizures can lead to an extremely life-threatening condition.

Usually they are of the same nature (only motor or sensory paroxysms), but with the progression of epilepsy, new types are added.

First aid

From the outside, a seizure may look intimidating, but there is nothing dangerous in it, as it ends quickly and spontaneously.

At this moment, the patient only needs the attention of others so that he does not harm himself by losing consciousness.

Human life will depend on correct and simple actions.

The algorithm is quite simple:

1. Don't panic when you witness epilepsy.
2. Pick up the person so that he does not fall, help him to smoothly fall to the ground, lay him on his back.
3. Remove objects that he can hit. It is useless not to look for medicine in his things. When he comes to, he will take his own pills.
4. Record the time of the onset of the attack.
5. Place something under your head (at least a bag or clothing) to soften head bumps. As a last resort, hold your head with your hands.
6. Free the neck from the collar so that nothing interferes with breathing.
7. Turn your head to one side to prevent tongue sinking and saliva asphyxiation.
8. Do not try to hold the limbs contracting in convulsions.
9. If your mouth is open, you can put a folded cloth or at least a handkerchief there to prevent biting on your cheek or tongue. If the mouth is closed, do not try to open it - you can be left without fingers or break the patient's teeth.
10. Check the time: if the seizures last more than two minutes, an ambulance should be called immediately - intravenous administration of anticonvulsants and antiepileptic drugs is required.
11. After the end of the attack, help the person recover, explain what happened and calm him down.
12. Help him take medication.

For patients with epilepsy, there are special bracelets on which all the necessary information is indicated. When calling an ambulance, this bracelet will help doctors.

Epilepsy is a chronic neurological disease in which an increased convulsive readiness is recorded. This pathology can develop at any age and affect how little childand an elderly person. The true causes of its occurrence in many cases remain unknown, which greatly complicates the treatment process. How to help the victim during a seizure, and what you need to know about this ailment?

What it is

It is an endogenous organic disorder of the central nervous system, characterized by seizures and pathocharacterological personality changes. Occurs "epilepsy" not only in humans, but also in animals (mice, cats, dogs). Epilepsy includes a number of syndromes and disorders associated with functional disorders of the central nervous system. At the same time, various psychopathological syndromes and symptomatic complexes are diagnosed, which gradually develop in the patient.

External signs of epilepsy in adults are not always manifested by loss of consciousness and seizures. The disease can proceed differently, in terms of absent-mindedness, weak muscle contractions of the limbs, fading.

The essence of the disease lies in the violation of the processes of excitation in the main organ of the nervous system, as a result of which a paroxysmal focus is formed: a chain of repeated discharges in neurons, which leads to the onset of an attack.

For the first time, a clear description of this ailment was given by Hippocrates. He attributed epilepsy to diseases of the brain, closely related to the disturbed activity of the nervous system.

Causes of occurrence

Why epilepsy develops, and what are the causes of its occurrence in adults, interests many people. The debut of the disease can be provoked by:

The first in women of mature age may be associated with hormonal disruption caused by menopause. In girls, pathology often manifests itself during pregnancy. In men, the cause of the development of the disease can be low testosterone levels or heavy drinking. Children face epilepsy when:

• pathologies of intrauterine development;
• prolonged fetal hypoxia;
• birth trauma;
• poisoning with toxic substances;
• mental disorders, neurosis, overstrain of the nervous system.

If we talk about what can provoke an epileptic seizure, then the patient should avoid:

• flickering light;
• loud intermittent sound;
• insomnia and lack of sleep;
• frequent stress;
• depressive state;
• psycho-emotional shocks;
• taking certain medications;
• drinking alcohol;
• unnatural (too deep or rapid) breathing;
• some types of physiotherapy.

Main symptoms

In milder forms, epilepsy in adults can be latent. Short-term loss of consciousness, some convulsive movements are perceived as an echo of overwork or stress. A more severe stage of the disease proceeds with pronounced symptoms: convulsions and seizures.

A few days before the attack, mood changes, apathy, nervousness, irritability, nausea appear. A person has a headache, blood pressure rises, general well-being worsens, hands or feet may tingle, smell and taste change. Experienced epileptics perfectly recognize pre-epileptic syndrome (aura) and anticipate an impending storm.

Not every seizure is considered epileptic. You can distinguish it by the following criteria:

• sudden onset at any time of the day;
• short duration. The duration of an episode can vary from a few seconds to a few minutes;
• self completion. The seizure does not require external intervention, since it stops on its own;
• tendency to regularity and frequency. In the absence of proper treatment, seizures that recur once a month, over time, occur more often and more severely;
• similarity of episodes. Often, the patient's each attack is no different from the previous one.

Signs neurological disorder in infants and young children, they do not particularly differ from the clinical symptoms of the disease in adults. Observed:

• spontaneous emptying bladder either the intestines;
• holding your breath;
• lack of response to stimuli;
• throwing back the head;
• sharp rolling of the eyes;
• fading (freezing).

Types and classification of pathology

There are no two patients in whom the disease is absolutely identical. Epilepsy is a multifaceted disease, and it has a lot of varieties:

• Symptomatic. It is characterized by local and generalized seizures due to organic changes in the brain (tumor growth, head trauma).
• Cryptogenic. It is accompanied by vivid signs of epilepsy in adult women and men, but without an identified cause. It occurs in 70% of patients. The most common subspecies is cryptogenic focal epilepsy. Its exact focus is established during examination.
• Idiopathic. Symptoms are manifested due to dysfunction of the central nervous system without organic changes in the brain structures.
• Alcoholic. Occurs due to toxic damage to the body due to abuse alcoholic beverages... Another binge can end for an alcoholic with an epilepsy attack during a hangover.

There is also non-convulsive epilepsy manifested by several subspecies:

• sensory seizures without loss of consciousness, in which vision, hearing, taste, smell are impaired, and dizziness is also observed;
• vegetative-visceral seizures, characterized by indigestion. The patient begins pains in the stomach, reaching the throat, nausea, vomiting, the cardiac and respiratory systems fail;
• mental attacks, accompanied by impaired speech, memory, consciousness, thinking.

Localization of foci is distinguished:

• temporal lobe epilepsy, accompanied by generalized seizures with loss of consciousness and simple local episodes;
• parietal epilepsy, in which focal simple seizures are recorded. Its first symptoms include impaired body perception, dizziness, visual illusions;
• frontotemporal epilepsy with the presence of an abnormal focus in the frontal and temporal lobes. Can cause both complex and simple seizures with a lack of consciousness and without loss of consciousness.

By the time of the debut, the form of the disease is:

• Congenital, manifested against the background of abnormal intrauterine development of the fetus.
• Acquired. It manifests itself as a result of the impact of negative factors that affected the integrity and functionality of the central nervous system.

There is nocturnal epilepsy when seizures occur during sleep. During the period of brain activity, a person can bite his tongue, scratch the body, hit his head, and in the morning he can not remember anything about what happened. As a rule, this type of disease over time flows into the daytime form.

First aid

Many people get lost if they suddenly witness an epileptic seizure. They act intuitively, trying to help the victim and sometimes committing the most unacceptable and dangerous actions for the patient. Experienced epileptics communicate on forums and recall teeth knocked out with metal objects, a torn tongue and other injuries received during the "first aid" by caring passers-by. To prevent similar mistakes, you should find out what to do if a person has an epileptic seizure:

• do not panic and immediately call an ambulance team if the attack does not end for more than three minutes;
• turn the victim on his side and try to protect his head from involuntary hits on a hard surface;
• put something soft under your head;
• if the patient regained consciousness, stay close to him until he finally orientates himself in the space around him.

Reducing the risk of injury from falls and seizures, and supporting the victim after the seizure is over are invaluable help from any outsider.

With an epileptic attack, you cannot:

• stick your fingers in your mouth trying to get your tongue;
• try to hold the patient, grab his arms or legs;
• put an object in your mouth;
• to unclench the jaws;
• pour water over the victim;
• screaming, hitting on the cheeks, bringing him to his senses;
• try to drink or give medicine.

Diagnostics

As soon as the first symptoms of epilepsy appear in a child or an adult, it is necessary to consult a neurologist or epileptologist. Such a person needs urgent examination and selection of appropriate treatment. Even if it was a single seizure, you should not hope that it will not happen again. The patient goes through:

• Electroencephalography. This method helps assess the activity of the brain and the electrical impulses it sends in all parts of the head.
• MRI is a highly informative diagnostic method that gives a complete picture of the state of the brain structures and the nervous system.
• Positron emission tomography - evaluates the functional activity of brain tissue, examines the metabolic processes of glucose, provides information about the saturation of cells with oxygen, the presence of tumors and abscesses.

Epileptic seizures in adults aged 30-40 years are recorded only in 15% of cases. Most of the victims are of old age.

Treatment

Even 20 years ago, epilepsy was considered a lifelong diagnosis, but even now the question of whether it is curable is in the first place. Medical statistics show that regular intake of AEDs (antiepileptic drugs) with a clear dosage can permanently relieve seizures or significantly alleviate the patient's condition. What kind of drug to choose is decided by the neurologist after receiving the test results. The most popular funds are:

• Carbamazepine (Finlepsin) is an anticonvulsant drug, a normotimic agent belonging to the group of carboxamide derivatives. It has analgesic, antipsychotic, antiepileptic effects.
• Oxcarbazepine (Trileptal) is prescribed for simple and complex partial seizures with or without loss of consciousness.
• Valproic acid (Valparin) - anticonvulsant, normotimic. Used for bipolar affective disorder, tics, epilepsy, convulsions, spasms.
• Lamotrigine - used for partial and generalized seizures, tonic-clonic seizures, Lennox-Gastaut syndrome.
• Phenazepam - used for phobias, anxiety, neurasthenia, tics, insomnia, epilepsy, disorders of the autonomic nervous system.

The daily dosage of tablets is determined by a specialist. Treatment of epilepsy with anticonvulsants is long-term, in some cases life-long.

If the selected medicine does not provide positive action, then the specialist either increases the dose or prescribes another agent. Cancellation of AED therapy occurs gradually, over six months or more.

In addition to taking medications, the patient must comply with some treatment conditions:

• adhere to a correct, balanced diet;
• do not drink alcohol, do not take drugs, do not smoke;
• do not abuse strong tea and coffee;
• prevent overheating, hypothermia, overeating;
• avoid stressful situations and other annoying factors that provoke another convulsive episode.

Folk remedies

Having identified the first signs of epilepsy in a child or an adult, you should immediately consult a doctor. As soon as the drug therapy is determined, you can use folk, home recipes. However, their use should be discussed with the treating specialist. Among the popular funds are:

• stone oil, which has antispasmodic and immunomodulatory properties;
• herbal preparations with peony, licorice root, duckweed, which have a calming effect;
• infusion of marin root with relaxing properties.

Surgical intervention

Surgical treatment for epilepsy is extremely rare, although most patients would like to undergo surgery and forget about seizures forever. A similar therapy is prescribed when the root cause of the disease is identified, requiring a radical approach:

• abscess of brain tissue;
• severe TBI;
• tumors;
• severe damage to cerebral vessels.

Forecasts and possible complications

In general, the prognosis for the treatment of epilepsy is favorable. Even if it is impossible to completely get rid of the disease, you can stop attacks or reduce their frequency. Many patients are helped modern drugsstabilizing the activity of the brain. However, it is almost impossible to recover from the disease itself forever.

With the refusal of treatment and uncontrolled epileptic seizures, various complications and serious consequences appear:

• status epilepticus occurs, in which seizures occur one after another. As a result, there is a serious disruption of the brain. Each severe seizure lasting more than half an hour irrevocably destroys a huge number of neural connections, which leads to a personality change. Often epilepsy in adulthood changes the character of the patient, causes problems with memory, speech, sleep;
• a patient who falls can receive a life-threatening injury.

If a person managed to stop seizures and refuse anticonvulsants, this does not mean that he is completely healthy. To remove the diagnosis, it will take at least five years, during which a stable remission is maintained, there are no complications, mental abnormalities, and encephalography does not reveal seizure activity.

Epilepsy is a fairly common disease of the nervous system, which is chronic in nature and is characterized by attacks of chaotic electrical activity in some parts and the brain as a whole.

In most cases, epilepsy is congenital, thus, seizures occur in children (aged from 5 to 10 years) and adolescents (in age category 12-18 years). In this situation, damage to the brain substance is not determined, changes affect only the electrical activity of nerve cells, and a decrease in the excitability threshold of the brain is also noted. This type of epilepsy is called idiopathic, or primary. It is distinguished by a benign course, it is safely treated, as a result, with age, the patient can completely exclude taking medications.

There is also symptomatic, or secondary, type of epilepsy. Its development is associated with the postponed damage to the structure of the brain or a failure in it metabolic processes, which are the result of a number of pathological influences (craniocerebral trauma, underdevelopment of brain structures, strokes, infections, tumors, drug and alcohol dependence, etc.). This form of epilepsy can develop in people of any age, it requires more complex treatment... However, in some cases, when it is possible to overcome the underlying disease, a complete cure is possible.

Types of epileptic seizures

The manifestation of epilepsy can be associated with very different kinds seizures. The classification of these types is as follows:
due to the appearance of seizures: primary and secondary epilepsy;
according to the scenario during an attack (an attack, accompanied or not accompanied by loss of consciousness);
at the location of the original focus excessive electrical activity (deep brain, left or right cerebral cortex).

Generalized seizures accompanied by complete loss of consciousness and the inability to control the actions performed. This is due to the excessive activation of the deep regions and the subsequent involvement of the brain as a whole. This state is not necessarily accompanied by a fall, since muscle tone is not disturbed in all cases.

When tonic-clonic seizure first, tonic tension of muscles of all groups occurs, followed by a fall, after which the patient has rhythmic flexion and extension movements in the jaw, head, limbs (so-called clonic convulsions).

Absances appear, as a rule, in childhood and accompanied by a suspension of the child's activity - his gaze loses awareness, he seems to freeze in one place, in some cases this may be accompanied by twitching of the facial and eye muscles.

Partial epileptic seizures noted by 80 % adults and in 60 % cases in children. They appear when a focus of excessive electrical excitability forms in a particular area of \u200b\u200bthe cerebral cortex. Depending on the place where such a focus is located, the manifestations of a partial attack also differ: sensitive, motor, mental and vegetative.

If the attack is simple, the patient is conscious, but cannot control a specific part of his own body, or notes sensations unfamiliar to himself. In the case of a complex attack, consciousness is impaired (partially lost), that is, the patient is not aware of what is happening around, where he is, however, he does not make contact. A complex attack, like a simple one, is accompanied by uncontrolled motor activity of a certain part of the body, in some cases it can acquire the character of a purposeful movement - the patient walks, talks, smiles, "dives", sings, "hits the ball" or continues the action he started before the onset of an attack (chewing, walking, talking). Both types of seizure, simple and complex, can result in generalization.

All types of seizures are transient - their duration is from a few seconds to three minutes. Most seizures, with the exception of absences, are followed by drowsiness and confusion. When an attack is accompanied by impairment or loss of consciousness, the patient does not remember what happened. The same patient may have different types of seizures, and the frequency of their occurrence may also change.

Interictal manifestations of epilepsy

Everyone knows that epilepsy manifests itself in the form of epileptic seizures. However, studies show that overestimated electrical activity and the brain's readiness for seizures do not leave patients even in the intervals between attacks, when at first glance there are no signs of illness.

The danger of epilepsy is that epileptic encephalopathy may develop, that is, a state in which mood decreases, anxiety appears, the level of memory, attention and cognitive functions decreases. This problem is especially acute in children, since it can cause developmental delays and hinder the formation of reading, speech, counting, writing, etc. skills. In addition, inappropriate electrical activity between attacks can cause serious illnesses such as migraines, autism, hyperactivity disorder, and attention deficit disorder.

Epilepsy causes

We have already said that there are two types of epilepsy: symptomatic and idiopathic. Most often, symptomatic epilepsy is partial, and idiopathic - generalized. This is due to various reasons that cause them. In the nervous system, signals between nerve cells are transmitted using an electrical impulse that is generated on the surface of all cells. Sometimes extra, redundant impulses appear, however, if the brain is functioning normally, these impulses are neutralized by antiepileptic structures. If there is a genetic defect in these structures, idiopathic generalized epilepsy appears. In such situation the brain does not control excessive electrical excitability of cells, as a result, it manifests itself as convulsive readiness, capable of "enslaving" the cortex of all hemispheres at any moment and leading to an attack.

Partial epilepsy characterized by the formation in some one cerebral hemisphere of a focus with epileptic nerve cells. These cells form an extra electrical charge. In response to this, healthy antiepileptic structures form a "protective shaft" near such a focus. Convulsive activity is restrained until a certain point, but the culmination comes when epileptic discharges break out of the shaft and take the form of an attack. Most likely, a second attack will come after a while, because the "road" is now open to him.

A similar focus with epileptic cells is formed in most cases against the background of some kind of disease or painful condition. Let's list the main ones:
brain tumors;
insufficient development of brain structures - does not appear as a result of genetic rearrangements (as in the case of idiopathic epilepsy), but during fetal maturation, it can be detected on MRI;
chronic alcoholism;
the consequences of a stroke;
traumatic brain injury;
central nervous system infections (meningoencephalitis, encephalitis, brain abscess);
receiving a number medications (neuroleptics, antidepressants, bronchodilators, antibiotics);
multiple sclerosis;
drug use (especially cocaine, amphetamines, ephedrine);
antiphospholipid syndrome;
row hereditary diseases metabolism.

Factors in the development of epilepsy

In some cases, the genetic defect does not take the form of idiopathic epilepsy and the person is not exposed to the disease. However, if “favorable” conditions (one of the conditions or diseases listed above) arise, some form of symptomatic epilepsy may appear. Moreover, in people at a young age, in most cases epilepsy develops after TBI and against the background of drug and alcohol dependence, and in older people - as a result of stroke or brain tumors.

Complications of epilepsy

If an epileptic seizure lasts longer than half an hour or if epileptic seizures follow one another and the patient is unconscious, the condition is called status epilepticus. This condition in most cases occurs if you abruptly stop taking antiepileptic drugs. The result of status epilepticus in a patient may be respiratory failure, cardiac arrest, ingestion of vomit into the respiratory tract and, as a result, pneumonia, as well as coma against the background of cerebral edema. Lethal outcome is not excluded.

Living with epilepsy

Many people believe that a person suffering from epilepsy has to limit himself in many ways, many paths of life are inaccessible to him, but living with epilepsy is not so difficult. The patient himself, as well as his relatives and people around him should know that, as a rule, an epilepsy sufferer may not even register a disability.

A full life is ensured by regular continuous intake of medications prescribed by your doctor. The brain, protected by drugs, loses its susceptibility to provoking factors. So the sick person can live full life, work (even at the computer), watch TV, play sports, fly on airplanes and so on.

However, there are several activities that affect the epileptic's brain like a red rag on a bull. Activities such as:
work with automated mechanisms;
driving a car;
cancellation or skipping of taking pills at will;
swimming in open water or in a pool without supervision.

In addition, there is factors that can lead to the occurrence epileptic seizure even a person without health problems, they also need to be careful:
regular use or abuse of drugs and alcohol;
work on night shifts, lack of sleep, daily work schedule.

Symptoms and signs of epilepsy

The signs and symptoms of epilepsy differ depending on the form of epilepsy and taking into account the characteristics of each patient. Symptoms are highlighted that preceded by a seizure; symptoms, accompanying the seizure; symptoms, following the seizure.

Harbingers of an epileptic seizure. Epileptic aura

Approximately one in five people with epilepsy begins to feel the approach of a seizure within some time (minutes, hours, days). Epileptic aura - it is a set of feelings and experiences that indicate the imminent onset of an epileptic seizure. It can be visual, somatosensory, olfactory, auditory, mental, gustatory.

An epileptic aura can manifest as a change in smell or taste, a feeling of nervousness or general tension, a feeling of deja vu, or an inexplicable certainty that a seizure is coming.

Symptoms and signs of an epileptic seizure

Epileptic seizures usually last from a couple of seconds to one to two minutes. The main symptoms of epilepsy are:
visual hallucinations;
an extremely strong feeling of a non-existent unpleasant or pleasant odor,
cases of "disconnection" of the patient and disappearance of the reaction to the surrounding reality,
cases of sudden loss of consciousness and muscle tone,
involuntary turn of the head to the side or involuntary bending of the body and head forward,
episodes of muscle twitching or rhythmic movements in the limbs that do not depend on the patient's will,
involuntary bowel movements or loss of urine accompanying loss of consciousness or seizures.

Epilepsy diagnostics

When a diagnosis of epilepsy is made, the main thing is to establish what character it is: secondary or idiopathic (that is, to exclude the presence of the underlying disease, which is the background for the progression of epilepsy), and in addition, the type of seizure. This measure is needed in order to correctly prescribe treatment. Directly the patient often does not remember how and what happens to him when an attack occurs. That is, the information that can be conveyed by the patient's environment, people present at the manifestations of epilepsy, is extremely important.

Research to be done:
EEG (electroencephalography) - reflects altered electrical brain activity. When an attack occurs, changes in the EEG are always visible. However, in the intervals between seizures, the EEG corresponds to the norm in 40 % cases, therefore provocative tests, repeated examinations and video-EEG monitoring are needed;
general and detailed biochemical analysis blood;
CT ( cT scan) or MRI (magnetic resonance imaging) of the brain,
if there is a suspicion of a specific underlying disease in the case of symptomatic epilepsy, the required additional examinations should be carried out.

Epilepsy therapy

The essence of epilepsy treatment is in normalizing the electrical activity of the brain and stopping seizures. To stabilize the membrane of nerve cells in the brain and thereby increase the level of convulsive readiness and reduce electrical excitability, antiepileptic drugs are prescribed. The result of such a drug effect is a decrease in the risk of another epileptic seizure. To reduce the excitability of the brain between seizures, which contributes to additional stabilization of the state and prevent the progression of epileptic encephalopathy, you can use litmictala and valproate.

Apply:
antiepileptic drugs such as valproate (depakin chrono), carbamazepine (finlepsin), topamax, lamictal, clonazepam, gabapentin and so on. The doctor decides which drug to choose and what dosage to use.
If the epilepsy is secondary, additional treatment of the underlying disease is carried out.
Symptomatic treatment (for example, medications to reduce depression or improve memory).

To protect themselves, patients with epilepsy must take antiepileptic drugs for a long time. Alas, drugs in this group can lead to the appearance side effects, such as lethargy, decreased cognitive activity and immunity, hair loss. For timely detection unwanted effects, every six months do ultrasound of the kidneys and liver, biochemical and general analysis blood.

The path to getting rid of epilepsy is long, thorny and requires a lot of energy, but through 2,5-3 years since the last attack, a comprehensive examination is again carried out, including MRI of the brain and video-EEG monitoring, and then the dose of the antiepileptic drug is gradually reduced until it is completely canceled. The patient leads a normal life, observes the same precautions, but he is no longer dependent on medication. A similar cure occurs in 75 % cases of epilepsy.